Managing flexible funding from 1 April

Changes are happening from 1 April to make flexible funding easier to use and give people more choice and control.

The flexible funding changes affect people who get Carer Support or hosted flexible funding – including Individualised Funding and some Enabling Good Lives Personal Budgets. (The changes do not apply to Choice in Community Living.)

From 1 April:

• People’s allocated budgets for flexible funding will continue the same as they are now.
• The purchasing rules for flexible funding will be removed.
• There will be more support from Hosts to help people manage their flexible funding in line with their plan.

Responsibilities for people using hosted flexible funding

Hosted flexible funding is when a person has a budget and a plan to arrange their own supports, and a Host helps them manage it.

Hosted flexible funding includes Individualised Funding and some Enabling Good Lives personal budgets.

Even though the purchasing rules will be removed from 1 April, flexible funding still comes with responsibilities. People need to:

• Use their flexible funding for disability supports that match the purpose in their plan.

• Stay within their budget and make sure it lasts for their full funding year. Hosts can help plan and track spending.
• Keep good records: receipts, invoices, and any employment records if they hire support workers.
• Send receipts for all items and invoices for contractors to their Host.
• Seek prior approval when required.

A Host’s job is to help people meet these responsibilities.

What flexible funding can be used for

Flexible funding can be used for supports, services, equipment, and activities – as long as the spending matches the purposes in their plan and their disability needs. Their plan could be their Individual Service Plan, Enabling Good Lives Funding Plan or My DSS Funding Plan.

Anyone who is unsure what their funding was allocated for can contact their Host, NASC, or EGL site.

What flexible funding cannot be used for

Flexible funding can never be used for drugs, alcohol, tobacco, gambling or illegal activities.

When people must talk to their Host before spending

People should ask their Host for prior approval before they spend on:

• Overseas travel
• Equipment
  • Approval is based on the equipment being safe and right for the person’s needs.
• Complementary therapies that aren’t publicly funded
  • Approval may be possible if recommended by a registered health professional, supported by evidence, and risks are managed.
• Repeat purchases of similar items before the item’s expected life is over
• One-off purchases over a set limit:

• • For people in support tiers one to three: $1,500
  • For people in support tier four: $500. (See below for more information about support tiers.)

After 1 April, your Host will be able to tell you what information is needed and how to request approval.

Other government services

Sometimes a support may also be available through another government service.

It is expected that a person and their host or NASC first consider whether these services could provide the support adequately and in time, before deciding to use flexible funding.

This doesn’t mean they can’t use flexible funding – it just helps make the best use of their available funding. The spending still needs to match the purpose of their plan and their disability needs. 

Their Host, NASC, or EGL site can help the person look at the options and record what’s been considered.

Support to manage flexible funding

From April, Hosts will provide more guidance, coaching, and oversight to help people manage their flexible funding.

Everyone with Individualised Funding or hosted EGL Personal Budgets will get some sort of support.

For some people it will be light touch, while for others it will be more frequent and active.

Support from Hosts can include:

• Helping people understand their plan and budget
• Supporting them with claims and record‑keeping
• Guidance, coaching and oversight with keeping records, budgeting, employing workers (if relevant).
• Checking that spending fits the person’s plan and budget, and helping adjust if needed
• Meeting as often as the tier indicates, and anytime extra help is needed.

Four tiers of support

There will be four tiers of support. Hosts will be in touch from April onwards to let people know which support tier they are on.

The tier of support a person gets will depend on the total flexible funding they get, their needs, and their experience and confidence managing their funding.

A tier can change over time. It does not change how much funding a person receives, or reduce choice or control.

Most people who get flexible funding will be in support tiers 1, 2 or 3, getting light to moderate levels of guidance.

Tier 1 – Low support

• The person is confident planning and managing their funding, making their own claims in line with their plan, keeping records, staying within budget and seeking prior approval, including for one-off purchases above $1,500.
• They need only occasional help, but can ask anytime.
• The Host checks in at least once a year.

Tier 2 – Some support

• The person manages most things, such as checking spending is in line with their plan, keeping records, and getting prior approval, including for one-off purchases above $1,500.
• They need a bit more help from time to time and can ask anytime.
• The Host checks in every six months.

Tier 3 – Regular support

• The person is newer to flexible funding or prefers more regular guidance. They still manage most things, such as checking spending is in line with their plan, keeping records, and getting prior approval, including for one-off purchases above $1,500.
• The Host checks in every three months and provides ongoing help.

Tier 4 – Frequent support

• The person needs frequent help, or closer contact is needed between the person, Host, and NASC or Enabling Good Lives site.
• They check all their purchases with the Host, agree about changes, keep receipts and get prior approval when needed, including for one-off purchases above $500.
• The Host checks in at least once a month.

For people who get Carer Support

The purpose of Carer Support is to enable full time carers to have a break from their caring role.

From 1 April:

• People’s allocated budgets for Carer Support will continue as they are now.
• Health New Zealand will no longer apply the current purchasing rules.
• Carer Support must still be used on respite options to give carers a break – but people will have more choice and flexibility over what works for them.
• People receiving Carer Support should continue to make their claims as normal through Health New Zealand.
• People may be asked to provide some additional information, such as receipts or invoices, when they make a claim. There will be more information about this before April.
• People with Carer Support need to stay within their budget and make sure it lasts for their full funding year.
• Carer Support cannot be used for drugs, alcohol, tobacco, gambling or illegal activities.
• Some things will require pre-approval, such as overseas travel and one-off purchases over $1,500. There will be more information before April on how to seek pre-approval.

Questions or complaints

• If a person’s needs or situation change, they should contact their NASC or EGL site.
• For help planning or managing their funding, they should talk to their Host.
• If someone is unhappy with their NASC, EGL site, or Host, they should speak with them first. People can also visit the DSS webpage: Complaints about disability support services.